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The 2007 Rwanda Service Provision Assessment (RSPA) was a national representative survey conducted in 538 health facilities throughout Rwanda. The survey covered hospitals, health centers, dispensar
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ies and
health posts, including all public facilities such as government and government-assisted health facilities. The 2007 RSPA used interviews with health service providers and clients and observations of provider client consultations to obtain information on the capacity of facilities to provide quality services and the existence of functioning systems to support quality services. The areas addressed were the overall facility
infrastructure, maternal and child health, reproductive health, tuberculosis, malaria services; and services for sexually transmitted infections and HIV/AIDS. The objective was to assess the strengths and
weaknesses of the infrastructure and systems supporting these services, and to assess the adherence to standards in the delivery of services.
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Suicides take a high toll. Over 800 000 people die by suicide every year and it is the second leading cause of
death in 15-29-year-olds. Most suicides occur in low- and middle-income countries where resources
and services, if they do exist, are of
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ten scarce and limited for early identification, treatment and support of
people in need. These striking facts and the lack of implemented timely interventions make suicide a serious
global public health problem that needs to be tackled urgently.
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Refugees and migrants face similar health threats from COVID-19 as their host populations. However, inadequate access to essential services and exclusion may makes early detection, testing, diagnosi
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s, contact tracing and seeking care for COVID-19 difficult for refugees and migrants thus increasing the risk of outbreaks in these population and presenting an additional threat to public health. This document offers guidance to Member States and partners for the inclusion of refugees and migrants, as part of holistic efforts to respond to COVID-19 epidemics in the general populations.
17 April 2020
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9 April 2020
The COVID-19 pandemic is presenting States in Europe with an extraordinary and unprecedented public health emergency. In response, States are taking necessary and legitimate measures
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to prevent the spread of the virus and to protect their populations. Some of these measures have been taken within the framework of a declared state of emergency, based on specific national provisions governing emergency situations.
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In fragile, conflict-affected and vulnerable settings, delivery of quality health services faces significant challenges, including disruption of a routine
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health service organization and delivery systems, increased health needs, complex and unpredictable resourcing issues, and vulnerability to multiple public health crises. Despite the difficulty of addressing quality in such settings, the necessity for action is acute, given the significant health needs of the populations in these environments and the increasing numbers of people for whom such settings are home.
This manual has been developed to provide a starting point for multi-actor efforts and actions to address quality of care in the most challenging settings. This includes practical approaches to action planning and implementation of a contextualised set of quality interventions.
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This update of the Guidelines for poison control, entitled Guidelines for establishing a poison centre, reflects the development of the role of poison centres in public health and the sound manageme
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nt of chemicals, described in section 1, and the opportunities provided by new technology. Assessments carried out under the IHR show
continuing gaps in capacity for managing chemicals (2). In particular, many countries still lack access to poison
centre services (3). There is therefore demand for updated guidance.
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This document is based on currently available scientific evidence on treatment for drug use disorders and sets out a framework for the implementation of the Standards, in line with principles of public hea
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lth care. The Standards identify major components and features of effective systems for the treatment of drug use disorders. They describe treatment modalities and interventions to match the needs of people at different stages and severities of drug use disorders, in a manner consistent with the treatment of any chronic disease or health condition. The Standards are aspirational, and such, national or local treatment services or systems need not attempt to meet all the standards and recommendations made in this document all at once. However over time, progressive quality improvement, with ‘evidence-based and ethical practice’ as an objective, can and should be expected to achieve better organized, more effective and ethical systems and services for people with drug use disorders.
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Assessment of non-communicable diseases (NCDs) service disruptions during the COVID-19 pandemic. Preliminary results.
Guidance on how to provide continuity for NCD programmes:• How to include NCDs in public
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health emergencies protocols?• How to develop national NCDs tool kits for use in emergencies?• How to provide ambulatory essential NCD services during lockdown?• How to provide medical care for NCDs through telemedicine and digital solutions?
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The recommendations in this guideline are intended to inform development of national and subnational health policies, clinical protocols and programmatic guides. The target audience includes national and subnational
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public health policy-makers, implementers and managers of maternal, newborn and child health programmes, health-care facility managers, supervisors/instructors for in-service training, health workers (including midwives, auxiliary nurse-midwives, nurses, paediatricians, neonatologists, general medical practitioners and community health workers), nongovernmental organizations, professional societies involved in the planning and management of maternal, newborn and child health services, academic staff involved in research and in the pre-service education and training of health workers, and those involved in the education of parents.
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HIV testing programmes need to ensure that all clients who test for HIV are provided with correct diagnoses. The accuracy of HIV testing is critical to prevent misdiagnosis, as the consequences of giving an incorrect test result can be serious for clients, HIV testing
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services, HIV programmes and public health.
With the evolution of global HIV epidemiology, HIV testing approaches must also evolve to maintain accuracy and efficiency in population-level diagnosis. Reports suggest that misdiagnosis of HIV status may occur when suboptimal testing algorithms and out-of-date testing strategies are used. As a result of changing epidemiology and declining HIV positivity in testing, WHO recommends all countries use a standard three-test strategy to ensure a PPV of at least 99%, minimizing false-positive misdiagnosis. The WHO-recommended HIV testing strategy, along with quality assurance measures such as retesting to verify a positive diagnosis prior to initiation of HIV treatment, is cost-effective as it prevents misdiagnosis and unnecessary initiation of costly lifelong treatment.
This implementation guide provides practical advice on switching to a three-test strategy and instituting other measures that can help national HIV programmes deliver high-quality, accurate HIV testing services and ensure that misdiagnosis is minimized.
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In 2014, the Ministry of Health (MOH) in Malawi conducted a nationwide assessment of emergency obstetric and newborn care (EmONC) services. This cross-sectional facility-based survey used 10 data co
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llection modules. Data collection began on 23rd September 2014 and concluded on 17th October 2014, in all 28 districts. Facilities in both the public and private sector (for-profit and not-for-profit) were included. Since the focus of the assessment was obstetric and newborn care, health facilities that did not offer maternal and newborn health (MNH) services were not selected. In all districts, a census of all hospitals and a 60 percent random sample of health centres that ought to have performed deliveries in the previous year yielded a total of 365 facilities: 87 hospitals and 278 health centres. All these facilities were visited during the assessment. During analysis, weighting procedures were applied to extrapolate results to the district and national level, representing all 87 hospitals and 464 health centres. Such weighting was necessary as a stratified random sample of health centres was taken and weighting applied to all indicators and presentations that have health facility as a unit of measurement. Case reviews and provider’s interviews, on the other hand, are not weighted as their sampling strategy is based on convenience.
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The seventh WHO Report on the global tobacco epidemic analyses national efforts to implement the most effective measures from the WHO Framework Convention on Tobacco Control (WHO FCTC) that are proven to reduce demand for tobacco.
The report showed that while only 23 countries have implemented ce
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ssation support policies at the highest level, 116 more provide fully or partially cost-covered services in some or most health facilities, and another 32 offer services but do not cost-cover them, demonstrating a high level of public demand for support to quit.
Tobacco use has also declined proportionately in most countries, but population growth means the total number of people using tobacco has remained stubbornly high. Currently, there are an estimated 1.1 billion smokers, around 80% of whom live in low- and middle-income countries (LMICs).
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Addressing comorbidities and risk factors for TB is a crucial component of Pillar one of the End TB Strategy, which focuses on integrated patient-centred care and prevention, including action on TB and comorbidities. The Framework for collaborative action on TB and comorbidities aims to support coun
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tries in the evidence-informed introduction and scale-up of holistic people-centred services for TB, comorbidities and health-related risk factors, with the goal of comprehensively addressing TB and other co-existing health conditions. It should be used in conjunction with relevant WHO guidelines. The Framework is intended for use by people working in ministries of health, other relevant line-ministries, policymakers, international technical and funding organizations, researchers, nongovernmental and civil society organizations, as well as primary care workers, specialist health practitioners, and community health workers who support the response to TB and comorbidities in both the public and private sectors.
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Throughout the Americas, populations are aging and the Region is undergoing a rapid demographic transition. The aging index, which reflects the size of the older age groups per 100 compared to children under age 15, clearly demonstrates the increase in people aged 60 and older. Compared to global tr
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ends, the Region of the Americas will have a larger number of people aged 60 and older than children under 15 by 2030, which is approximately 25 years before the global average. The COVID-19 pandemic has presented an unparalleled health crisis around the world. The impact on older persons and those with underlying health conditions has highlighted the challenges of addressing the needs of older populations during a public health emergency. Given this demographic transition it is essential to think about preparedness of systems and services to address this population’s needs, including an increase in emergency planning and protection of older populations.
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Emergency medical teams (EMT) are first response health care providers – doctors, nurses, paramedics, and others – during outbreaks and emergencies or disasters, working with governments, charities such as nongovernmental organizations (NGOs), a
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rmies, and international organizations such as the International Red Cross/Red Crescent movement. They comply with the classification and minimum standards set by the World Health Organization (WHO) and its partners and bring to an emergency their training and self-sufficiency so as not to burden the national health system. EMT initiatives strengthen national surge capacities and facilitate the deployment of internationally classified teams of health- care professionals to countries and territories during emergencies, particularly during disease outbreaks and natural disasters, providing immediate assistance when national health systems are overwhelmed . Considering that they aim to support the provision of quality clinical care services to populations affected by public health emergencies, the expectation is that financial resources and equipment will be available to enable the performance of the requested task.
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The webpage from the Pan American Health Organization (PAHO) discusses the heightened risk that individuals with noncommunicable diseases (NCDs)—such as cardiovascular diseases, diabetes, and cancer—face regarding severe illness and mortality fr
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om COVID-19. It emphasizes the necessity of informing the public about these health risks and adapting healthcare services to ensure the continuity of essential NCD care during the pandemic. The page provides information and guidance for healthcare providers and the public on managing NCDs in the context of COVID-19, highlighting the importance of addressing NCDs and their risk factors with a medium- to long-term perspective.
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The webpage from the Pan American Health Organization (PAHO) discusses the heightened risk that individuals with noncommunicable diseases (NCDs)—such as cardiovascular diseases, diabetes, and cancer—face regarding severe illness and mortality fr
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om COVID-19. It emphasizes the necessity of informing the public about these health risks and adapting healthcare services to ensure the continuity of essential NCD care during the pandemic. The page provides information and guidance for healthcare providers and the public on managing NCDs in the context of COVID-19, highlighting the importance of addressing NCDs and their risk factors with a medium- to long-term perspective.
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ince the introduction of multidrug therapy (MDT), there has been significant progress in reducing the prevalence of leprosy and the occurrence of new cases. Global strategies have evolved with progress in reducing the disease burden. Encouraged by the decrease in the number of cases on treatment, th
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e World Health Assembly passed a resolution calling on Member States to accelerate efforts towards global elimination of leprosy as a public health problem by 2000.
Most countries reached the milestone by 2010. The global strategies for 2006–2015 focused on sustaining high-quality leprosy services and early diagnosis. Reduction in the disease burden was measured in terms of grade-2 disability (G2D) or visible deformities in new cases. Since 2016, the strategies have included reduction of stigmatization of people with leprosy.
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This document is written for medical doctors, clinical officers, medical assistants, nurses, midwives, health surveillance assistants (HSAs), and medical records clerks who are working in public and
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private sector health facilities in Malawi. It is designed to be a practical guide for implementation of integrated HIV services.
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Noncommunicable diseases (NCDs) are responsible for 81% of all deaths in the region of the Americas, of which 34% befall prematurely in people between 30- 69 years old. The burden of theses diseases and their common risk factors jeopardize the health
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systems to provide adequate management, as well as to implement customized policies and interventions. The PAHO/WHO STEPwise approach to NCD risk factor surveillance (STEPS) is a simple, sequential, standardized method for collecting, analyzing, and disseminating data on key NCD risk factors in countries in adults from 18 to 69 years old. This survey covers key modifiable risk factors: tobacco use, alcohol use, physical inactivity, and unhealthy diet, as well as key biological risk factors: overweight and obesity, raised blood pressure, raised blood glucose, and abnormal blood lipids. STEPS is a household survey that gathers information on the risk factors through a face-to-face interview (step 1), simple physical measurements (step 2), and collection of urine and blood samples for biochemical analysis (step 3). Every step has a core set of questions, measurements, and expanded sets depending on the countries' needs and interests. It also has optional modules. Implementing STEPS allows the comparability of data within and between countries due to its standardized data collection. It also helps health services plan public health priorities and monitors and evaluates population-wide interventions. It is designed to help countries build and strengthen their capacity to conduct surveillance. STEPS captures 11 of the 25 indicators outlined in the NCD Global Monitoring Framework relating to 7 of the nine global targets.
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